effect of aripiperazole in treatment of psychotic mania

INTERVENTION: Intervention 1: Litium combined with Tabiet Aripiprazole(30 mg/day) as intervention group for 3 weeks. Intervention 2: Litium combined with Tablets Risperidon(6mg/day) as control group for 3weeks. Litium combined with Tabiet Aripiprazole(30 mg/day) as intervention group for 3 weeks. Litium combined with Tablets Risperidon(6mg/day) as control group for 3weeks. Treatment ‐ Drugs CONDITION: bipolar affective disorder Condition 1: mania. Condition 2: bipolar disorder. ; bipolar affective disorder ; bipolar affective disorder PRIMARY OUTCOME: Severity of manic phase and psychotic symptom. Timepoint: Baseline and days 7‐14‐21 after beginig of treatment. Method of measurement: YMRS. SECONDARY OUTCOME: Akatezia. Timepoint: days 2‐4‐7‐10 after beginig of treatment then every weeks. Method of measurement: BARS. Diskinesia. Timepoint: days 2‐4‐7‐10 after beginig of treatment then every weeks. Method of measurement: SAS. Extrapyramidal. Timepoint: days 2‐4‐7‐10 after beginig of treatment then every weeks. Method of measurement: AIMS. INCLUSION CRITERIA: criteria: Age more than 18 years; Diagnosis of Bipolar disorder with psychotic symptom based on DSM‐IV TR; Ongoing treatment with Litium as a mood stabilazor with seromic level between 0.8‐1.2meq/L ; patient with YMRA>20.Exclusion criteria: Mental Retardation; Pregnancy or Breast Inclusion feeding;Any chronic medical problem; substance abuse; Any other psychiatric Disorder in Axis I OR II;Allergic to Aripiprazole and other Atypical Antipsychotic drug ;History of epileptic disorder; Delirium state.